Woman's Rare Case of 'Seasonal OCD' Cured

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A rare case of "seasonal" obsessive-compulsive disorder in a
woman in highlights the complexity of this mental health
condition, researchers say. The woman's OCD symptoms appeared
every year when winter began, and then ended as the seasons
shifted toward summer.

After living with the condition for a decade, the woman was
treated at a clinic and recovered, the case report said.

Patients with other
mental health conditions, such as depression, may also get
worse in the winter and feel better again in the summer, Forman
said.

The 41-year-old woman came to an outpatient clinic during the
month of October. She said she was having distressing thoughts
about dirt and contamination, and that her thoughts were causing
her to engage in repetitive cleaning rituals, and to repeat the
same words for long periods of time. She said her symptoms had
appeared every October for the past 10 years, always disappearing
completely by April or May.

But "gradually, over the years, she noted that the severity of
her illness increased," and it was disrupting her life and her
relationships, the researchers who treated the woman wrote in the
case report. [ 5
Controversial Mental Health Treatments ]

The doctors initially prescribed the woman a drug called
fluoxetine, which affects levels of the neurotransmitter
serotonin in the brain and is used to treat
people with OCD and depression. But after a month of that
treatment, her condition was not much improved.

The woman then began attending therapy sessions, during which she
was gradually exposed to the cues that typically triggered her
OCD symptoms, and learned to overcome them. The researchers also
prescribed the woman a light treatment, that exposed her to
bright light for two hours daily. They thought the seasonal
variation in her condition might have something to do with
receiving an inadequate amount of light, according to the case
report.

The woman's condition improved after 14 days of the new therapy
regimen. The doctors recommended she continue to take the
fluoxetine, and the woman's OCD symptoms did not come back the
next winter, according to the report.

Previous research had shown that some OCD patients might indeed
experience seasonal variations in symptoms, according to the
report.

"I felt like this case is very much clearly a case of seasonality
of obsessive compulsive disorder, and I think we should not
necessarily be so surprised that this could happen," Forman said.

It is not exactly clear why some patients with mental health
disorders get worse as seasons change, he said. There are
seasonal variations in
how much serotonin is produced in the body, with less
produced during darker and colder months compared with months
that are sunnier and warmer. But there is no convincing evidence
that this variation in serotonin production causes the changes in
people's symptoms.

In patients with depression, for instance, it is also possible
that less socializing with family and friends during wintertime
plays a role in worsening symptoms, Forman said.

The case report was published online Feb. 18 in the Industrial
Psychiatry Journal.